I am an obstetrician and a member of the Missionary Sisters of the Holy Rosary. Over the past 25 years I have had the privilege of working with other members of my congregation to improve the health of the poor in Zambia.
Over this period of time I have come to understand the many causes of hardship and suffering in this country. When things seemed to be difficult enough for the poor - then came the HIV virus.
Zambia is foremost amongst the countries affected by the HIV/AIDS epidemic. With an estimated adult HIV prevalence rate of 10% - 15% in rural areas and 25% - 30% in urban, Zambia is considered to be in the heart of the African AIDS belt.
By the end of 2001 it is estimated that Zambia will have one million orphans. Many of those orphans are the future parents of Zambia. The psychological impact on these children in losing both parents at such an early age has yet to be considered. Death and dying are such everyday experiences for them that they accept without any expression of emotion.
In 1984 when this disease was first recognized and its tragic consequences spelt out at a National Conference organized in 1985 and attended by the then world experts, the Churches Medical Association of Zambia, an ecumenical body of missionaries and Church workers set about organizing AIDS Care & Prevention programmes.
Personnel in Health Institutions were released for full-time work in organizing these programmes and today all our Zambian missionaries and Church workers are involved in Home Based Care activities, Behavior Change Programmes (Youth Alive), Care of Orphans and Hospice care for the terminally ill AIDS patients.
The AIDS pandemic in Zambia today is compounded by poverty. AIDS is not only a disease of the poor, but the poor are the worst affected. 80% of the Zambians today live below the poverty line. Therefore unless the issue of poverty is addressed, little progress will be made in combating this dreadful disease.
Poverty worsens the AIDS situation as families affected cannot afford adequate nutrition, medical care, education for their children, their meager resources often swallowed with funeral expenses, long term care of family members etc.
It is sadly not uncommon for a mother to send the daughter out to trade sex for income. Sexual services without condoms can demand more money. The average young woman in such circumstances will tell you she prefers to die of AIDS that see herself or her children die of starvation.
Because of poverty 600,000 children missed school in 1999 - many of these are todays street children. Between 1993 and 1996, Zambia's annual average spending on debt servicing was more than four times the spending on education, and almost twice the amount spent on all social services. Despite the Jubilee 2000 campaign debt still remains a major issue
The economic and poverty situation are issues for good governance. With these issues addressed I believe there is hope for the youth, the educated youth. Many of these have formed a Youth Alive Programme. This is a Behavior Change and Education for Life Process which originated in Uganda in 1988 and was adopted in Zambia in 1996.
It has been acknowledged that this programme contributed dramatically to the reduction of AIDS in that country and hopefully will be a beacon of hope for Zambia too. All the strategies that have been put in place so far seem not to have worked. It would be more than worthwhile if some donor country was brave enough to put its support behind such a programme.